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NPI Code Detail

MEDICARE: STARR LISA O'NEAL

MEDICARE:   STARR LISA O'NEAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1417278607
Entity Type Code : Individual
Provider Name (Legal Business Name) : STARR LISA O'NEAL
Provider Business Mailing Address
First Line : 7160 RAFAEL RIVERA WAY STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-5394
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7160 RAFAEL RIVERA WAY STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-5394
Country : US
Telephone Number : 870-972-4939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2010
Last Update Date : 07/30/2024

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Directions to “ STARR LISA O'NEAL ” Practice Location

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